Percutaneous Radiofrequency Ablation (RFA) for Renal Tumors Larger than 4 cm

Purpose To evaluate technical success and long-term outcomes of radiofrequency ablation of T1b renal tumors. Material and Methods Ninety-four biopsy proven renal tumors (size 8 to 65 mm) in 80 patients were treated with percutaneous RFA. Mean patient age was 67.8 years (range 37 to 90 years). The percutaneous ablation was carried out under US/CT guidance in all patients. Seven of 94 tumors were T1b staged (mean size 43.81 mm; range 40 to 47.2 mm). Imaging follow up was performed by contrast-enhanced CT at 24 hours, at 45 days, and then at 6-month intervals after treatment. Results In T1b tumors group, 4 lesions were completely ablated after a single RFA session while 3 patients had residual tumor: 1 was radically treated after a second session and another is still waiting for a second RFA. The last patient was not retreated due to deterioration of his performance status (ASA 4). The overall technical success rate of this cohort is therefore 71.4%. No major complications occurred. Conclusions RFA is safe and effective in T1b renal tumors in well-selected patients, but retreatment should be sometimes considered in order to achieve a satisfactory outcome.